| NPI | 1972560761 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: SD 1491) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NC 8775) |
| 225100000X Physical Therapist (Licence: MN 6215) | |
| Enumeration Date | 2006-04-27 |
| Last Update Date | 2016-05-10 |